Comparison of antithrombin activity assays in detection of patients with heparin binding site antithrombin deficiency: systematic review and meta-analysis.

Antithrombin (AT) deficiency increases the risk for venous thromboembolism, therefore, a highly sensitive assay to identify this condition is crucial. The aim of this paper was to perform a meta-analysis comparing AT activities measured by different AT activity assays in patients with heparin binding site AT deficiency. In addition, the diagnostic sensitivity of selected assays was compared depending on the available data. An extensive literature search was performed considering results with publication date up to July 10, 2021. Seven relevant English-language observational studies, comparing AT activity measured by different AT activity assays in Caucasian Europeans with either the AT Budapest III or AT Padua I mutation were included in meta-analyses. There was no significant difference in AT activity between Labexpert and Innovance in patients with AT Budapest III (P = 0.567) and AT Padua I (P = 0.265), while AT activity determined by HemosIL was significantly higher compared to Innovance for both mutations (AT Budapest III: P < 0.001; AT Padua I: P < 0.001). These results are in line with the results of comparison of diagnostic sensitivity. In patients with AT Budapest III, the AT activity was also higher when measured with Berichrom compared to Innovance (P = 0.002), however, the results of comparison of diagnostic sensitivity across studies were variable. No significant difference (P = 0.117) in AT activity as well as diagnostic sensitivity was observed between Sta-Stachrom and Innovance. The results of our study suggest that Innovance, Labexpert and Sta-Stachrom are the most sensitive activity assays for detection of AT Budapest III and AT Padua I, whereas HemosIL showed considerably lower sensitivity for these two variants. As revealed in our study, the diagnostic sensitivity of AT activity assays to type II heparin binding site AT deficiency is different, and in some assays mutation dependent.

International Trends in Health Science Librarianship Part 20: The Balkan States (Serbia and Slovenia).

This is the 20th in a series of articles exploring international trends in health science librarianship in the 21st century. The focus of the present issue is the Balkan region (Serbia and Slovenia). The next regular feature will look at Russia and the Ukraine. JM.

Do open access biomedical journals benefit smaller countries? The Slovenian experience.

Scientists from smaller countries have problems gaining visibility for their research. Does open access publishing provide a solution? Slovenia is a small country with around 5000 medical doctors, 1300 dentists and 1000 pharmacists. A search of Slovenia's Bibliographic database was carried out to identity all biomedical journals and those which are open access. Slovenia has 18 medical open access journals, but none has an impact factor and only 10 are indexed by Slovenian and international bibliographic databases. The visibility and quality of medical papers is poor. The solution might be to reduce the number of journals and encourage Slovenian scientists to publish their best articles in them.